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Prostatic Artery Embolization: Mid- to Long-Term Outcomes in 1,075 Patients.

Shivank Bhatia¹, Ansh Bhatia¹, Andrew J Richardson¹

¹Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, Florida.

Journal of Vascular and Interventional Radiology : JVIR

|November 12, 2024

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Prostatic artery embolization (PAE) offers sustained relief for lower urinary tract symptoms (LUTS) and improves quality of life in men with benign prostatic hyperplasia (BPH). This large study demonstrates PAE

Area of Science:

Urology
Interventional Radiology
Men's Health

Background:

Benign prostatic hyperplasia (BPH) is a common condition causing lower urinary tract symptoms (LUTS).
Prostatic artery embolization (PAE) is an minimally invasive treatment option for BPH.
Long-term safety and effectiveness data for PAE are crucial for clinical decision-making.

Purpose of the Study:

To evaluate the mid- to long-term safety and effectiveness of PAE.
To assess outcomes in a large cohort of 1,075 patients undergoing PAE for LUTS or urinary retention.

Main Methods:

Retrospective analysis of 1,075 patients who underwent PAE between January 2014 and July 2023.
Assessment of International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function-5 (IIEF-5), prostate-specific antigen (PSA), prostate volume (PV), and postvoid residual.

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Adverse events (AEs) were recorded and classified using Society of Interventional Radiology (SIR) criteria.

Main Results:

Significant and sustained improvement in IPSS and QoL scores observed up to 60 months post-PAE (P < .001).
94% of catheter-dependent patients were catheter-free at 3 months; 65.5% were free of BPH medication at 1 year.
A low reintervention rate (16%) and a low incidence of severe AEs (0.65%) were reported, with all AEs resolving without permanent sequelae.

Conclusions:

PAE provides significant, sustained long-term relief of LUTS and improves QoL in a large patient cohort.
PAE demonstrates a low reintervention rate and high rates of BPH medication independence.
The procedure is safe, with a low rate of severe adverse events and excellent outcomes for catheter-dependent patients.